title: Hepatic steatosis assessment with CT or MRI in patients with colorectal liver metastases after neoadjuvant chemotherapy.
abstract: OBJECTIVE
  Preoperative radiological assessment of hepatic steatosis is recommended in patients undergoing a liver resection, but few studies investigated the diagnostic accuracy after neoadjuvant chemotherapy. The aim of this study was to compare diagnostic accuracy of preoperative CT or MRI measurements of steatosis in patients with colorectal liver metastases after induction chemotherapy.
  
  
  METHODS
  MRI measurements (relative signal intensity decrease; RSID), N = 36, and CT scan measurements (Hounsfield units; HU), N = 32, were compared with histological steatosis assessment. Diagnostic accuracy was determined for detecting any (>5%) or marked macrovesicular steatosis (>33%).
  
  
  RESULTS
  MRI showed the highest correlation with histology (r = 0.82, P < 0.001), compared to CT measurements (r = -0.65, P < 0.001). Based on linear regression analysis, radiological cut-off values for 5% and 33% macrovesicular steatosis, corresponded to 0.7% and 19.2% RSID in the MRI-group, and 60.4 and 54.2 HU in the CT-group, respectively. Sensitivity and specificity for the detection of any and marked macrovesicular steatosis using MRI was 87% and 69%, and 78% and 100%, respectively, and for CT, 83% and 64%, and 70% and 87%, respectively.
  
  
  CONCLUSIONS
  In patients treated with neoadjuvant chemotherapy MRI measurements of steatosis showed the highest correlation coefficient and the best diagnostic accuracy, as compared to CT measurements.
authors.affiliation: Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: H A
authors.initials: HA
authors.lastname: Marsman
authors.forename: A E
authors.initials: AE
authors.lastname: van der Pool
authors.forename: J
authors.initials: J
authors.lastname: Verheij
authors.forename: J
authors.initials: J
authors.lastname: Padmos
authors.forename: F J W
authors.initials: FJ
authors.lastname: Ten Kate
authors.forename: R S
authors.initials: RS
authors.lastname: Dwarkasing
authors.forename: T M
authors.initials: TM
authors.lastname: van Gulik
authors.forename: J N M
authors.initials: JN
authors.lastname: Ijzermans
authors.forename: C
authors.initials: C
authors.lastname: Verhoef
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005234:Fatty Liver / Q000139:chemically induced / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome